Clinical application of a model-based cardiac stroke volume estimation method (2020)

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Type of Content
Journal ArticlePublisher
Elsevier BVISSN
2405-8963Language
enCollections
Abstract
Abstract: A system is needed for monitoring stroke volume (SV) and cardiac output (CO) in unstable patients which is non-additionally invasive, reproducible and reliable in a variety of physiological states. This study evaluates SV estimation accuracy of a non-additionally invasive pulse contour analysis method implemented using a 3-element Windkessel model. The model lumps the properties of the arterial system into 3 parameters: characteristic impedance of the proximal aorta (Z), and resistance (R) and compliance (C ) of the systemic arteries. Parameter products ZC and RC are dynamically identified from measured femoral arterial pressure waveforms, and Z is a static parameter obtained by calibration. The accuracy of the model is evaluated for a cohort of 9 liver transplant patients, using thermodilution as a reference method. Data were obtained from Vital Data Bank (VitalDB). The study thus provides independent assessment of a pulse contour analysis, proven in animal studies, in an uncontrolled clinical environment. The model tracked trends in SV well over the course of the surgery. However, the 95% range for percentage error was -88% to +53%, outside acceptable limits of ±45%. Main areas contributing to error for the model include the changing extent of reflected waves in the arterial system, dynamic response characteristics of fluid-filled pressure catheters, and the assumption of fixed Z parameter. Further investigation is needed to consider the contribution of theses factors to SV estimation error by the model.
Citation
Smith R, Balmer J, Pretty CG, Shaw GM, Chase JG (2020). Clinical application of a model-based cardiac stroke volume estimation method. IFAC-PapersOnLine. 53(2). 16137-16142.This citation is automatically generated and may be unreliable. Use as a guide only.
Keywords
Pulse contour analysis; Pressure contour analysis; Windkessel model; Stroke volume; Cardiac output; Hemodynamic monitoring; Intensive careANZSRC Fields of Research
32 - Biomedical and clinical sciences::3202 - Clinical sciences::320212 - Intensive care32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320101 - Cardiology (incl. cardiovascular diseases)
40 - Engineering::4003 - Biomedical engineering::400306 - Computational physiology
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Incorporating pulse wave velocity into model-based pulse contour analysis method for estimation of cardiac stroke volume
Smith, Rachel; Balmer, Joel; Pretty, C.G.; Mehta-Wilson, T.; Desaive, T.; Shaw, Geoff; Chase, Geoff (Elsevier BV, 2019)Background and Objectives: Stroke volume (SV) and cardiac output (CO) are important metrics for hemodynamic management of critically ill patients. Clinically available devices to continuously monitor these metrics are ... -
Improved pressure contour analysis for estimating cardiac stroke volume using pulse wave velocity measurement
Kamoi S; Pretty C; Balmer J; Davidson S; Pironet A; Desaive T; Shaw, Geoff; Chase, Geoff (2017)Background: Pressure contour analysis is commonly used to estimate cardiac performance for patients suffering from cardiovascular dysfunction in the intensive care unit. However, the existing techniques for continuous ... -
Clinically Applicable Model-based Pulse Contour Analysis Method for Stroke Volume Estimation
Smith R; Balmer J; Pretty C; Shaw, Geoff; Desaive T; Chase, Geoff (2019)